Am J Perinatol 2017; 34(05): 480-485
DOI: 10.1055/s-0036-1593352
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transcutaneous Carbon Dioxide Monitoring with Reduced-Temperature Probes in Very Low Birth Weight Infants

Safwat Aly
1   Department of Pediatrics, Children's National Medical Center, The George Washington University, Washington, District of Columbia
,
Mohamed El-Dib
2   Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
,
Mohamed Mohamed
3   Division of Newborn Services, Children's National Medical Center, The George Washington University, Washington, District of Columbia
,
Hany Aly
3   Division of Newborn Services, Children's National Medical Center, The George Washington University, Washington, District of Columbia
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Publikationsverlauf

16. Juni 2016

19. August 2016

Publikationsdatum:
27. September 2016 (online)

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Abstract

Background Obtaining blood gases in very low birth weight (VLBW) infants is an invasive procedure. Studies using transcutaneous carbon dioxide (tcPCO2) have reported variable skin complications with high-temperature probes. No enough data available on tcPCO2 monitoring using reduced-temperature probes (41°C).

Objective The objective of this study was to assess reliability and safety of tcPCO2 monitoring at reduced-temperature probe in VLBW infants.

Design and Methods A prospective study was conducted on VLBW infants. tcPCO2 was monitored for 12 hours. Default skin probe temperature was adjusted at 41°C. Blood gases were done as clinically indicated. Arterial partial pressure of CO2 (PaCO2) as well as capillary CO2 were compared with simultaneous tcPCO2.

Results A total of 124 data points were identified from 50 patients (gestational age [GA] = 28.1 ± 2.4 weeks and birth weight [BW] = 1,035 ± 291 g). Patients were supported with continuous positive airway pressure (40%), noninvasive positive pressure ventilation (16%), mechanical ventilation (18%), and high-frequency oscillation ventilation (24%). PaCO2 was measured using either capillary (58%) or arterial (42%) samples. Mean CO2 did not differ between tcPCO2 (51.3 ± 16) and PaCO2 (49.1 ± 13.7) mm Hg. tcPCO2 showed positive correlation with partial pressure of CO2 (r = 0.6, p < 0.001). This correlation continued to be significant after controlling for GA, postmenstrual age, type of sample, and pH. No skin complications were reported.

Conclusion tcPCO2 monitoring using a temperature of 41°C is feasible and reliable in VLBW infants.